Provider Demographics
NPI:1316510712
Name:SHOEMAKER, CAITLYN JAHN (MS, RDN, LDN, EDRC)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:JAHN
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:MS, RDN, LDN, EDRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 N UNION ST
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08530-2001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:89 N UNION ST
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08530-2001
Practice Address - Country:US
Practice Address - Phone:908-892-4509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADI61314829OtherCERTIFIED DIETITIAN NUTRITIONIST (CDN)
MANU-NU-5365OtherLICENSED DIETITIAN NUTRITIONIST (LDN)
PADN007567OtherLICENSED DIETITIAN NUTRITIONIST (LDN)